Health Care Archive

June 19, 2008

 Be afraid of that cheesesteak, very afraid: Can we bring public health into the 2008 campaign?

Reporters have been ribbing Barack Obama over his apparent reluctance to eat fatty foods. Michelle Malkin asserts that anyone afraid of a cheesesteak isn't ready for Bin Laden. In his apparent fastidiousness, Obama realizes something the reporters don't. The campaign may look like a sprint, but he wants to stick around for what promises to be an exhilarating long-distance run. Me too.

May 18, 2008

 Everything old is new again

Reading this story about heading off expensive litigation by just saying you're sorry, I had a flashback to a meeting twenty-five-odd years ago from which I learned important management lessons. For really mysterious reasons, I had been appointed to a state commission to deal with what then felt like a malpractice insurance crisis, and called Charles A. Sanders, then general...

May 11, 2008

 Some people who need a raise more than you do...

Caregivers for the disabled earn not much more than the college student who brewed your last latte. They need a raise.

May 04, 2008

 The McCain plan: "Health insurance for people who don't need health care"

It's terrible policy and lousy politics: if the Democrats have a candidate who can make that point.

May 01, 2008

 Dinde Clinton et dindon Obama à la sauce Krugman

Contra Krugman, there's a good campaign parallel between health care and climate change.

April 21, 2008

 Netherlands bicyclists

OK, one last post on Dutch velocipedal culture, because another reader reminded me of what may its most remarkable convention: no helmets! This one is really perplexing. Obviously, the only people who should wear a bicycle helmet are those who (i) use their heads for thinking or (ii) wish to appear as though they do; many Dutch people meet one...

April 17, 2008

 Take this employer-based health coverage and shove it

One much-neglected goal of healh care reform is to free people from jobs they'd like to quit by decoupling employment from health care coverage.

April 12, 2008

 Comparison

Lack of health insurance kills more people every year than murderers do.

March 30, 2008

 A small but important issue that involves no sex, evildoers, or conflict

In my short career as a health policy blogger, I have learned that any posting that screams “Screw the insurance companies!!” attracts many groupies who salute me with raised Zippo lighters outside the family home. Criticizing the purveyors of bogus links between vaccines and autism will also attract a crowd. These people deploy the same lighters to more hostile effect. Postings that address knotty problems that lack evildoers, hysteria, and conflict attract…well pretty much nobody. Consider S2743, the Financial Security Accounts for Individuals with Disabilities Act. Are you still reading? You may be the only one.

March 23, 2008

 The Real McCain

McCain's tax and health-care proposals ought to help focus progressive attention on November rather than Obama-v.-Clinton sniping.

March 09, 2008

 Placebos, antidepressants, and government mendacity

Antidepressants seem to be only somewhat more effective against depression than placebos, and the finding has triggered a fair amount of discussion of health care costs (how much are we spending for drugs that don't work much better than sugar pills?) and of course lots of technical back and forth about the studies themselves. Am I ever not going to...

March 06, 2008

 Every day is Veterans' Day

Whatever their views on the war, few Americans claim not to "support the troops." Yet outrage over the way returning and discharged troops are treated seems fairly thin on the ground. The Walter Reed scandal was too graphic not to garner a lot of attention, if not for long. But the routine indifference and even hostility to veterans, from the...

February 28, 2008

 This may cause a little discomfort

Obama is right to propose federal spending on electronic medical records.

February 25, 2008

 Gimme an Rx!

Vaxidrine is, like, sooo much better than Xozophrinol!

 Pharmaceutical marketing

It's worse than wasteful. And $70 billion is a lot of money. It wouldn't be necessary if we made physicians keep up with the literature.

February 23, 2008

 Health and Habits

As the health policy debate cranks up, attention is properly paid to all the ways we can be healthier that aren't medical and surgical treatment of illness. Most of these are well-known (cut down on the salt, get some exercise, stop smoking, and all that good stuff on the Kaiser ads). Some dangerous recreation is obviously bad for you, like...

February 16, 2008

 Why do we have a private health insurance industry again?

In my brief experience in the blogosphere, my first lesson has been that writing the words "insurance companies" reliably prompts the largest number of R-rated responses. This is not surprising, since people are so regularly provoked to the inhumanity and pervidity of our private insurance system. I and other not-especially radical folks increasingly scratch our heads to wonder: Why do...

February 04, 2008

 Pollack on Krugman on Gruber on mandates

The "finding" that the Clinton health plan would provide essentially universal coverage that Paul Krugman touts in his column yesterday turns out to be a bare assumption.

February 03, 2008

 Enough with the "mandates," already!

This is not an issue worth making a headline argument about. Both Democratic candidates support making health coverage available and affordable to anyone who wants it. The rest is commentary.

February 02, 2008

 Concerning spine and clean needles

Needle exchange for addicts is like driver's licenses for illegals. The merits point one way, the politics point the other way. Guess which of the two Democratic candidates is facing the right way?

 In comicus veritas

The best commentary on anti-contraception lunacy is in a cartoon.

February 01, 2008

 Universal coverage, individual mandates, etc.

More than 80 clinicians and health policy experts have signed a statement noting the importance of health reform, noting the similarity across Democratic health reform plans, and noting the ways that one issue—the individual mandate—has taken on undue prominence in the presidential and health policy debate. Several of us associated with RBC are signatories....

January 29, 2008

 The cultural production of ignorance.

This Thursday’s episode of an ABC court drama perpetuates the groundless and harmful myth that vaccines contribute to autism. Why are the penalties so low for spreading these falsehoods? Why does junk science (in its actual rather than its corporate bumper-sticker formulation) continue to attract such a following?

January 18, 2008

 Harold Pollack on health services and Obama

Harold Pollack on the heatlh care issue and the campaign: "Our medical and public health system is a mess. It won’t be fixed until we choose a Democrat who can actually win the presidency, and who can then assemble a working majority to get things done." Pollack thinks that Democrat is named Obama.

January 07, 2008

 Health-care cost containment and Nataline Sarkisiyan

Should controlling health care expenditure be a prime objective in health care finance reform? If so, are we willing to deny liver transplants to people like Nataline Sarkisiyan?

October 19, 2007

 Don't just do something! Stand there!

"Doctors and parents need something for ill children, even if it has no proven effect." Now there's logic for you!

October 17, 2007

 Physical health and health

The NYT gives us the health facts about margarine and butter. Bottom line: "Margarine generally contains less fat and cholesterol than butter, but it is not ideal." I'll say, and not because of it's trans fats. It's a fairly short story, but nowhere in it does the author recognize that how they taste might have anything to do with the...

October 03, 2007

 S-CHIP as a campaign issue

This has to be a gift for the Democrats, because the Republican Presidential candidates are forced to side with the President against a highly popular program that fits easily into a 10-second spot.

September 23, 2007

 Seek the Paths of the Dead

Estimating the number of American babies who would have lived had the USA matched Taiwan.

August 22, 2007

 Is American health going backwards?

The USA isn't sliding down the world rankings for life expectancy, but its performance is still very mediocre.

August 16, 2007

 Let 'em eat assisted suicide

Someone is going to trot out this story of a man who killed his wife in despair over not being able to pay her medical bills to argue for universal health care, so let me clarify in advance: this tragedy resulted because the couple disrespected the wisdom of their elected leader. They should have just gone to the emergency room,...

August 10, 2007

 Simple Answers to Simple Questions: National Review on Health Care

With apologies to Atrios. From The Plank: When, I wonder, will [the National Review's] editors shed these dishonest scare tactics and begin to analyze the Democrats' actual proposals while offering serious, substantial alternatives? Never. This has been another edition of simple answers to simple questions....

July 16, 2007

 Iatrogenic stress, health-insurance variant

What's the health impact of making patients worry about huge medical bills?

 Malign processes, not malign people

No, back when I had cancer there wasn't some insurance company bureaucrat personally stalling the approvals for my diagnostic work in hopes that I'd give up and pay the extra co-payments under "Tier II." There was simply a slow and clumsy process that created an incentive for people in my position to buy their way out of waiting.

July 14, 2007

 Projection

Rich Lowry needs a good mirror.

July 13, 2007

 Making old, poor smokers pay for children's health care

Elderly smokers damage their lungs. That's not a good reason to make them pay through the nose.

July 12, 2007

 Rationing health care

Canadians wait for hip replacements. Americans wait for all sorts of health care, sometimes fatally. The difference is that we don't keep count. And THAT's an argument against reform? Pah.

June 28, 2007

 Wonk Smackdown--Drug Price Policy Edition

If this is the best that Andrew Sullivan can do in responding to Kevin Drum on health care policy, then he should stick to torture (writing about it, I mean). The backstory is that Andrew, with some help from Mark, is convinced that what he (inaccurately) calls "socialized medicine" will destroy drug innovation. Kevin responds by saying nonsense: all it...

June 26, 2007

 Do U.S. consumers support world pharmaceutical innovation?

Probably. That's not a reason not to try to squeeze down on drug prices, but it is a reason to worry about the effects of that squeeze on innovation.

June 14, 2007

 Prizes for inventing new drugs?

I can't find any details, but apparently John Edwards will propose replacing drug patents with prizes for innovation. That's a huge idea, and probably a good one. Some incentive for innovation is necessary, but the award of monopoly rights via patent isn't the only, or the best way to create that incentive. Under a patent system, drugs are priced above...

June 04, 2007

 Time to exhale

I landed on Andrew Speaker last week with all four feet and a couple of readers have since pointed out that I was probably out of bounds. If he knew what we know now about the communicability of his infection, he was certainly not sociopathic nor grossly irresponsible. Sorry. But he was jerky and irresponsible; the risk of causing another...

May 31, 2007

 He what?? !! ...so he could WHAT??!!!

Update: A couple of readers point out that this is over-the-top in view of unfolding news; backoff here. Now this gives "to have and to hold, in sickness and in health" a whole new meaning. TB is spread feebly by casual public content (coughing in public places) but effectively by prolonged, intimate contact in closed spaces. If you have XDR-TB,...

May 26, 2007

 Health care policy vs. health

Why are politicians allowed to put forward "health" proposals that focus entirely on health care finance? And why are progressives in particular seemingly indifferent to the rate of progress in our ability to prevent and treat disease?

May 06, 2007

 No majority against "partial birth abortion"?

Apparently not. I'm pleasantly surprised.

April 23, 2007

 Haley Barbour's banal evil-doing

Is cutting off prenatal care so that poor infants die in greater numbers "murder"? Not really. But it is killing for money.

 Policy and murder

Mark is right to deplore Haley Barbour's savage idea that Mississippi (of all states) would benefit from cutting social services to its poorest people, and the deaths of innocents traceable to the policy are fairly charged to it. But it isn't murder, and I differ from his rhetoric. Many policy choices entail a gross cost in shortened lives, even shortened...

April 22, 2007

 Wilful murder

Haley Barbour cuts Medicaid. Infant mortality soars.

March 21, 2007

 Off the reservation

The Director of NIH, a Bush appointee, finally speaks out for embryonic stem cell research.

February 18, 2007

 Bill Frist in Democratic dress

A psychiatrist, speaking as a psychiatrist, ought not to purport to diagnose people he hates as a means of attacking them politically.

February 10, 2007

 Girls, boys, bioethics, chastity, and the HPV vaccine

The HPV vaccine would be less controversial if it were being given to boys instead of girls. How bad bioethics mates with bad psychology to produce bad politics.

 (Bad) benefit-cost analysis and the HPV vaccine

One more silly argument against (quasi) mandating vaccination for the Human Papilloma Virus.

February 07, 2007

 The Right-to-Cancer movement

Who's against mandatory HPV vaccination, other than loony libertarians? Why, the "Right-to-Life" folks, of course.

January 28, 2007

 Thanks for explaining that

If you think the Bush health plan is puzzling, Stephen Colbert can straighten you out.

January 25, 2007

 Obama on health care

Barack Obama is too smart (I hope) to have an excuse for giving the speech he just gave on health care.

January 23, 2007

 On Efficiency

Arnold Kling of the Cato Institute, who has given President Bush's alleged health care plan an "A+," criticizes my criticisms. I argued that the method of capping the deductibility of employer-based health coverage seemed like a lousy method of paying for tax credits for the uninsured (which are themselves a poor way to get people insured). In addition to setting...

 On Efficiency

Arnold Kling of the Cato Institute, who has given President Bush's alleged health care plan an "A+," criticizes my criticisms. I argued that the method of capping the deductibility of employer-based health coverage seemed like a lousy method of paying for tax credits for the uninsured (which are themselves a poor way to get people insured). In addition to setting...

January 22, 2007

 Cell phones and cancer again

Last week I posted a note deploring sloppy and alarmist scientific journalism. My point was about the journalism, but along the way I indicated that the lack of a bump up in brain cancers while cell phone use has been exploding at least suggested a very minimal risk. The science on this is still contradictory and changing, with responsible scientists...

January 20, 2007